As mentioned in my previous post, in his essay “Who is the mad voice inside?” Dr Michael Sinason uses an incident from C.S. Lewis’ The Great Divorce to illustrate the concept of the “cohabiting other mind”.
The passage in question is quoted at length in section 3.0 of Dr Sinason’s essay, and tells the story of a “Ghost” – one of the inhabitants of hell who are brought to heaven – with a red lizard on his shoulder. The lizard makes the Ghost’s (after)life a misery, but the Ghost is at first unwilling to allow an angel to kill the lizard. In Dr Sinason’s application of this account, he takes the Ghost to represent the patient, the lizard “the versatile voice of the psychotic personality”, and the Angel the therapist.
He highlights a number of ways in which Lewis’ story illustrates the nature of the relationship between patient and therapist, all of which are worth reading, but a couple of which I will mention here:
1. The Ghost never expected to be able to be truly free of the influence of the Lizard because he thought that the liberating process would kill him. There was really no expectation that a new life without the domination of illness could be achieved and that the attempt would cost the patient his life and that he thought it better therefore to be resigned to the impairments that accompany the cohabitation.
I found this very striking, as (even setting aside the “internal cohabitation” theory) it helps explain why even “non-psychotic” people can be trapped by destructive patterns of behaviour: getting into debt, staying with an abusive partner or parent, and so on. People have “no expectation” that life can be any different, and feel that breaking even with a miserable situation would be a form of death. Those of us not in those situations can find it very hard to imagine being trapped by that sort of thought-process, which can lead to unsympathetic responses to those so affected.
5. There is one area where this allegory exposes an important clinical issue which is difficult to address. The Angel appears to have murderous intentions towards the Lizard and shows no concern or interest in the lifelong involvement of the Ghost with the Lizard. All concern for the Lizard is left to the Ghost who in fact shows quite a lot of concern which is overridden by the Angel’s refusal to consider a gradual way of dealing with the Lizard. This has all the hallmarks of an abuse situation where for example a therapist would get fed up with the slowness of the progress of a patient and the frequency of the negative therapeutic reactions and be driven to propound some much more radical action treatment.
Hmm. Is the Angel an abusive therapist? Surely the difference is that the Angel was able to effect a quick and complete cure. Therefore it was right to do so – just as illnesses that would once have involved years in a sanatorium can now be cured in days or weeks using antibiotics. It is not “abuse” or “impatience” that leads a doctor to prescribe antibiotics as a treatment for TB, but the previously-unavailable ability to effect a cure.
Where the abuse comes in is where a human therapist forgets that they are not an angel with powers of immediate cure. So Dr Sinason’s warning is probably well-placed, but misinterprets the story itself (as indeed he does in his description of The Great Divorce, which is emphatically not about “Lewis’s concern about the perennial wish to make a marriage between heaven and hell” – but that’s another matter).